Machine-to-machine (M2M) technology has the potential to transform healthcare and create a continuum of care, despite limited resources.Applied in the field of mobile healthcare (mHealth) M2M can advance health in developed countries through efficiency gains as well as in developing nations where M2M can assist in creating healthcare for the masses.
The challenges of healthcare today
On the verge of a brave new world where everything can be connected, we are also at a crossroads in medicine. In the early 1900s, communicable diseases like Spanish flu were the most dangerous threats known to man.
Today, chronic ‘welfare diseases’ such as diabetes, heart disease and other recurring conditions top the list of health threats that impact the greatest number of people and contribute to the high cost of modern healthcare worldwide. Statistics indicate that by 2020 at least 160 million Americans are projected to have at least one chronic condition.
According to research by the Continua Health Alliance, there are more than 1 billion overweight adults in the world today, a risk factor for chronic diseases such as high blood pressure, cardiovascular disease and more. In the United States, 90% of healthcare spending goes toward treating chronic diseases.
This challenging situation is compounded by the fact that the overall world population is ageing: by 2050 the over-60 population in the world will outnumber the under-15 population for the first time in history. At this age, morbidity risks increase disproportionately which increases the burden on healthcare systems. Delivering affordable healthcare is one of the biggest challenges faced by any government and in many countries healthcare expenditure is growing at unsustainable rates.
How can mHealth and M2M provide an answer?
Given these current and future challenges, it’s no surprise that the medical industry is turning to wireless technology — specifically M2M technology — to bring about much needed improvements in healthcare that greatly reduce the cost of treating these conditions and improve the overall quality of life for millions around the world. Wireless technology has given us the ability to stay connected to people, data, machines and devices and it greatly improves productivity, efficiency and general ease of living. Wireless infrastructure has been in place for decades and the healthcare industry is quickly finding ways to capitalise on this advantage to solve critical challenges faced by an overburdened healthcare system.
Telehealth or mHealth describe medical technology and monitoring devices that integrate cellphonebased or M2M-based wireless communications to improve patient treatment. Unobtrusive and easy to use mobile health devices can suit a variety of telehealth purposes. This includes monitoring a patient’s medication compliance, managing elderly patients through wearable health monitors and helping chronic disease patients proactively and reactively manage their personal care. Personal emergency response systems (PERS) can automatically call for help, enabling emergency services to react faster. Complementing face-toface visits, M2M technology establishes an additional communication channel between clinicians and patients, removing geographic barriers and enhancing the quality of service delivery
The author is Manfred Kube, director, Business Development mHealth at Cinterion, a Gemalto company.
Consistent and real-time oversight can greatly improve treatment, keep patients healthier and avoid expensive hospitalisation. In fact, a recent study by Philips showed compelling and tangible benefits gained from telehealth solutions: 89% of health agencies reported an increase in quality outcomes, 76% cited reduction in unplanned hospitalisations, 77% cited reduction in ER (emergency room) visits and 76% reported patients improving self-care by proactive disease management.
Wireless technology and services have evolved and expanded rapidly and can now provide critical relief to the overburdened healthcare system. Medical device manufacturers are developing and launching a new breed of mHealth solutions using M2M modules that will undoubtedly solve some of these challenges. An independent market study predicts that the market for telehealth and home health monitoring for the US and EU combined will grow from US$3 billion in 2009 to an estimated $7.7 billion by 2012. Mobile network operators now recognise M2M applications as generally lowbandwidth solutions with little churn, and most have embraced the promise of M2M technology which is accelerating the mHealth revolution.
Similarly, advances in module and sensor technology such as miniaturisation and smart textiles are enabling unobtrusive, simplified applications for telehealth applications that can provide continuous medical support outside of the doctor’s office or emergency room. Comfortable and convenient sensors, such as those placed into a discrete watch, increase mobility and independence while providing the sense of security knowing that help is just around the corner, making mHealth solutions more attractive to patients.
Security as a key ingredient for successful mHealth solutions
Trust is indeed a key requirement for mHealth applications which must exchange data securely and reliably to maintain strict confidentiality. GSM modules from providers like Cinterion have been proven in industries that require the highest quality, security and reliability standards. The extremely rigorous specifications for utmost reliability and traceability required for telehealth applications are similar to the stringent automotive industry standards where M2M has been widely applied for many years. Challenges such as securing user data and privacy have already been successfully mastered in M2M solutions such as point of sale terminals and automated teller machines.
With over 15 years of experience in digital security, Gemalto technology enables healthcare devices to communicate over wireless networks in a highly secure fashion. Data transmission is based on the latest encryption technologies and security mechanisms inherent in modern cellular networks. Gemalto also supplies healthcare providers with strong authentication solutions, ensuring only authorised personnel can access sensitive patient data. By combining M2M technology, embedded secure elements like smartcards and other solutions Gemalto and Cinterion can significantly improve end-to-end security in wireless networks, safeguarding patient information and meeting regulatory requirements.
How to reach scale with M2M-based mHealth solutions?
With the core technology in place for M2M-based applications, it is interoperability of these solutions that is one of the main inhibitors for mHealth solutions to reach scale today. Cinterion is committed to support standards such as those adopted by the Continua Health Alliance, where more than 200 member companies are working to establish a standardised ecosystem of interoperable personal health solutions that empower people and organisations to better manage health and wellness. However, healthcare is an extremely conservative industry, and the pace of uptake of new technologies is very slow when compared to the mobile industry.
Another lingering inhibitor to mHealth adoption has been creating viable business models and reimbursement schemes. Insurance companies have been slow to approve coverage of mHealth solutions until clinically proven success is documented. At the moment, there are various multi-sided business models emerging which feature cross-subsidisation from different players in the ecosystem. In addition, there’s a growing evidence base for the economic benefits and some promising developments in the reimbursement for telehealth by national healthcare systems.
Summary
We are at a crossroads in medicine where the increasing pressure of skyrocketing healthcare costs is motivating technological innovation and invention. Innovation, proven medical outcomes, improved quality of life and convenience, plus mobile network operator support are fueling mHealth adoption. The opportunity to help and transform is here, and it will take the collaborative effort by wireless and medical industry stakeholders to usher in a much needed paradigm shift in healthcare delivery
